Overuse of Orthopedic Care

Dr. James Rickert, founder of the Society for Patient Centered Orthopedic Surgery, is on a crusade to stop overuse in his specialty area, orthopedic care, which he describes as “one of the worst offenders.”

At a recent conference of the Lown Institute, he called out five specific procedures which are frequently performed, usually unnecessary, high cost and sometimes harmful. The specifics are detailed in this recent HealthLeaders article. It’s a quick, worthwhile read.

He points to examples of how our current system supports overuse of healthcare:

• Fee for service payments – where doing a procedure is more lucrative than providing conservative treatment.
• Physician ownership or financial interest in orthopedic devices or imaging equipment where use generates revenue to physicians.
• Desire to try something – Physicians and patients alike may be inclined to try something and patients may perceive they have little to lose if they aren’t fully aware of the potential risks.

The QualityPath program addresses many of the underlying causes of overuse. QualityPath designated doctors and hospitals:

• Use evidence-based protocols to ensure patients receive appropriate high tech imaging tests;
• Involve patients in the decision-making process when there is more than one right treatment approach. Patients make decisions with full knowledge of the risks and benefits
• Prohibit physicians from receiving industry payments or require them to be disclosed to patients

These criteria, plus a track record of good performance, help increase the odds of good outcomes for patients.